Reducing maternal and child mortalities in Nigeria

AT a recent gathering of journalists by a collective of health-oriented Non-Governmental Organisations (NGOs), under the aegis of Mothers and Beyond International, with the support of the UK Department For International Development (DFID), fearful details on the status of the healthcare delivery system in Nigeria were revealed. Though the statistics were shocking, it, however, showed how to reduce these unwarranted morbidity and mortality rates in the country.

It is disheartening that between 80 and 85 percent of all health related issues in Nigeria affect women and children. Nigeria was declared the 189th worst nation on some basic health indices by the United Nations recently. About 200 of every 1,000 Nigerian children die from malaria, pneumonia, and diarrhoea before their fifth birthday. Only five die in the United States of America.

Results of the Goal four of the recently rested Millennium Development Goals (MDGs) programme, to reduce child mortality; five, to improve maternal health; and six, to combat HIV/AIDS, malaria and other diseases, were just short of dismal for Nigeria. For example, by 2008, only 5.5 percent of children slept under insecticide-treated mosquito nets.

The Goal five is to improve maternal health in the country, but are we really working towards achieving this goal? Maternal mortality refers to deaths due to complications from pregnancy or childbirth. From 1990 to 2015, the global maternal mortality ratio declined by 44 percent, and everyday, approximately 830 women die from preventable causes related to pregnancy and childbirth; 99 percent of all maternal deaths occur in developing countries.

Maternal mortality is higher in women living in rural areas and in poorer communities, the maternal mortality ratio in developing countries in 2015 is 239 per 100,000 live births, as against 12 per 100,000 live births in developed countries. Young adolescents face a higher risk of complications and death as a result of pregnancy than other age group of women.

A woman’s lifetime risk of maternal death — the probability that a woman will eventually die from a maternal cause — is one in 4900 in developed countries and one in 180 in developing countries, but in countries designated as fragile states, the risk is one in 54; showing the consequences from breakdowns in health systems.

Women die as a result of complications during and following pregnancy and childbirth. The major complications that account for nearly 75 percent of all maternal deaths are; severe bleeding (mostly bleeding after childbirth), in fictions (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery and unsafe abortion.

Five women die of childbirth every hour in both rural and poor urban centres in Nigeria. This is because most pregnant women have little access to health facilities; are too young, especially in Northern Nigeria; do not space their pregnancies; or do not feed well. With fewer children, the food goes round, and the ravage of breast-feeding on malnourished mothers are reduced.

Family planning facilities and delivery that can reduce maternal death are inadequate. Again, the Nigerian state fails to provide counterpart funding to complement the foreign donors. And sometimes, donated family consumables are abandoned by callous state agents. Most Nigerian women now seek alternative herbal medicine, not out of choice, but because the private hospitals are far too expensive, relative to government hospitals that lack requisite drugs, and keep them all day on the Out Patient Department (OPD) benches.

Because section 33(1) of the Nigerian constitution guarantees right of life to all, it is a constitutional responsibility for the Nigerian state to ensure that feeding and healthcare, both basic requirements for life, are available to all Nigerians without discrimination. One rule of thumb to achieve this is to concentrate on the health issues that concern reproduction (or pregnancy), mothers, newborn babies, and the adolescents children. In the long terms, this strategy reduces general mortality rate, it also guarantees a healthy and productive citizenry.

There are many pregnant women in distance villages with no access to healthcare or facilities for delivery; these women either give birth in their homes unattended to, or are hurried-off to the nearest town, which may be several miles away in search of maternity clinics or hospitals, and that is, provided they have the right means of transportation, let us not forget that our roads are also terrible to travel on.

Women education, which must include enlightenment programmes on immunisation, adequate feeding, family planning, spacing of children, and general health information, must be intensified. Somebody said if you educate a woman, you educate a nation.

However, men, religious leaders and traditional leaders should be recruited into the vanguard to save Nigerian women and children. A constructive engagement of the menfolk, who have immense authority, as husbands and policy-makers in Nigeria’s male-oriented environment is critical to healthcare delivery.

• Orunbon, a public affairs analyst, sent in this article from Abeokuta, Ogun State.